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General NPI Number Information
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NPI Number | 1831224260
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Entity Type | Individual
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Provider Name | TERRY M. RANTA D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 14420 W MEEKER BLVD
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-5286
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Country | US
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Telephone | 623-972-6131
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Fax |
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Provider Business Mailing Address
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Address Line | 15887 W WINDSOR AVE
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City | GOODYEAR
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State | AZ
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Zip | 85338-1428
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Country | US
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Telephone | 623-535-1230
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 651
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License Number State | AZ
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